Inspection on 12/06/06 for Clayton House

This inspection was carried out on 12th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Clayton House 14/07/05

Clayton House 08/11/04

Clayton House 16/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Clayton House 11 Lea Road Gainsborough Lincs DN21 1LW Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 12th June 2006 10:00 Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clayton House Address 11 Lea Road Gainsborough Lincs DN21 1LW 01427 613730 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kingsway Mrs Kathleen Mccoull Mrs S Aunger Care Home 16 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (1) of places Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: The home is an adapted property, achieved through converting two semidetached properties into a detached unit. It is situated in the town of Gainsborough, close to all the main facilities and services. There is a small front garden and a combined back garden, which offers privacy to residents in the summer. The home provides accommodation for sixteen residents who have a learning disability. They are accommodated in three double bedrooms and ten single bedrooms. Accommodation is provided on the ground and 2 further floors with communal facilities located on the ground floor. There are no shaft lifts or chair lifts in this home and all those residents who live in this home are ambulant. The homes philosophy of care is to enable residents to live as independent a life as possible in a homely environment. The current scale of charges at this home starts at £392.00 to £406.00 per week. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with the residents who was being case tracked and joined five other residents for lunch. The inspector also spent time with the homes activities co-ordinator, one member of staff, the trainee manager and the registered manager. A partial tour of the home accompanied by a resident and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The home has addressed the requirements from the last inspection. They have installed window restrictors in all first floor windows and replaced a number of double glazed windows throughout the home. New carpets have been fitted as well as a two-seated settee, a new shower and tiles in the utility room have also been fitted. The homes medication sheet are now signed by the carer who administers the medication and interview notes were seen to be kept in care workers files. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home carries out care assessments with other agencies prior to admission. The home informs prospective residents in writing whether they can meet their needs. EVIDENCE: A review of all information available prior to this inspection and evidence seen at a previous inspection carried out in November 05 demonstrates that the home would admit residents only after a care needs assessment being undertaken with other health care agencies. The home has not admitted a new resident since 2003. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. The letter also contains the terms of conditions of residence and asks if the prospective resident or relatives have any concerns, however, slight to contact the home as soon as possible. Residents care files seen in November 05 contained full and ongoing assessments of residents needs and reviews are held, in which social services and health care professionals are involved. All those aspects of care required Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 9 are addressed including meaningful educational opportunities, cultural and faith needs and contact with families and friends. Questionnaires sent to the home prior to this inspection by The Commission showed that of the eight returned all commented that they had received a contract and information about the home prior to admission. One resident also commented that ‘I visited the home (prior to admission) on three or four occasion and joined everyone for meals’. Another written comment was ‘It’s a beautiful house and I’m happy living here’. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9. The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s individual needs are promoted and documented appropriately. Residents are empowered at reviews and take a full and meaningful part. EVIDENCE: A review of all information available prior to this inspection and a previous key inspection carried out in July 05 and November 05 at this home has evidenced that residents had an individual detailed care plan. This inspection found that the two residents who were being case tracked their care plans had been reviewed on a regular basis and reflected the changing needs of the resident. Both care plans were also signed and dated by the residents. From the documentation and from discussion with residents it was clear that they were fully aware of the plan, the changes and why it had changed and the goals towards which they were working. Residents risk assessments and reviews had also been signed by residents agreeing to the risk identified and/or the change in their care plan and how this might effect their daily living. Residents Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 11 commented that they felt their rights were respected and their key workers or other staff gave support when required. The home operates a key worker system, residents have a say in whom their key worker is and also who they wish to go on holiday with. Residents who were being case tracked said that ‘I have signed my care plan and my social worker comes to see me once a month’. A social worker was contacted and confirmed that he undertakes eleven reviews on behalf of residents at this home on the 22nd and 23rd March 2006. He stated that residents and the manager attend reviews, which are well organised with risk assessments and last years reviews made available by the home. He further commented that the manager is ‘happy to work with other professionals and is flexible in her approach the care that can be offered’. The home’s last residents’ meeting was held on the 01/06/06, the minutes showed that fourteen residents attended. Issues discussed included, the homes recent in house quality assurance survey, the recent holiday in Great Yarmouth and the forthcoming holiday in Scarborough. Residents made comments relating to future trips and general issues were mentioned concerning the running of the home. Two residents confirmed that they were actively involved in residents meetings and this year decided where they wished to go for their holiday. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16, & 17 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Service users had busy and varied lifestyles with opportunities to engage in a range of leisure and cultural activities within the community. The home actively encouragers relatives and friends to visit the home and maintain links with residents. The residents have a varied diet and mealtimes are treated as a social occasion. EVIDENCE: Previous inspections of this home has shown that each resident has a calendar of weekly events and activities. A number attend a local authority day centre, whilst other access daily activities from the home. Some residents attend the Monday drama group, which is held in the Gainsborough arts centre. A regular disco is also held in town, which is a firm favourite with residents. Some seven residents go to church on a Sunday and a priest attends the home on a monthly basis for bible studies. One resident has been baptised and now attends church to carryout his duties as an ‘alter server’. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 13 The homes pre-inspection questionnaire evidences the activities and leisure pursuits are undertaken by residents. These activities include meals out, walks, shopping, visits to the library and church attendance. The home has a newly adapted computer room for those residents who do not attend a day centre. They told the regulator that they undertake Distance Learning as well as a variety of other activities during the day and evening. The homes day care worker asked a resident to demonstrate his skills which he was happy to do so, exhibiting a good knowledge base and a keen interest in the task set for him. Anther resident showed the regulators the garden in which they are growing strawberries. A member of staff said that all residents are treated respectfully and training undertaken in the home highlights the need to maintain their dignity. She also stated that residents have their own safe to keep their valuables in and only they know the combination. She also confirmed that six residents have their own keys to their rooms. Eight residents questionnaires returned to The Commission showed that seven felt that activities are always available to them and one resident felt that they are usually available. Previous inspections of this home has shown that files of residents who were being case tracked gave details of visits to and from relatives and friends. A cursory look at residents care plans confirmed that residents are still supported in retaining contact with relatives and friends. Staff provide appropriate guidance and support to service users with regards to personal relationships to ensure they had sufficient information on which to make informed decisions. The homes quality assurance survey conducted in May 06 for relatives/friends resulted in three replies. Comments made were that they were kept informed about important matters affecting their relative and one stated that ‘this is the best care home I have ever been in’. The residents questionnaires demonstrated that six felt that they received the support that they needed and one felt they usually received support and one felt that the local authority day service sometimes gave him the support that he needed. The homes quality assurance survey undertaken in December 05 evidenced that residents are happy with the home, the holidays they undertake during the year and the food at this home. The regulator joined five residents for lunch and they said that the meals are good at this home and they discuss the menu anytime they want with staff. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 14 Residents questionnaires showed that seven always liked the meals and one resident usually liked the meals. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, & 20 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Service users received personal and health care in line with their needs and independence in all areas was encouraged. Personal support is only given to residents with their consent. The administration of medication was appropriately recorded. EVIDENCE: Previous inspections of this home have shown that residents files recorded the health care input they require. During discussions with residents, they confirmed that they see GPs, dieticians and psychiatrists. The pharmacist visited on 22/05/06 and the report showed that the administration records and storage and stock control was good and that training was up to date, with all residents being assessed for none self administration of medication. Medication sheet were seen to have been signed by the person giving the mediation and there were no gaps. Due to this no inspection by the regulator of medication was undertaken. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 16 A review of all information available prior to this inspection and a previous key inspection carried out in November 05 showed that care plans highlight those areas in which residents require personal support in various aspects of their daily living. A care worker stated that residents are treated as adults and are treated with respect. Observation by the regulator was that residents are able to express their needs and during this inspection was happy and free to do so. Residents confirmed that they have a say in how they live their lives and what help they need. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. The home has the appropriate adult protection policies and guidance. EVIDENCE: Previous inspections of this home have shown that adult protection information was in place for the information of care workers. This included the Lincolnshire Adult Protection Guidance, and DOH No Secrets document. Discussion with a carer showed that she had a clear understanding of what adult abuse was and what action she would take if this came to her attention. The homes training file showed that adult protection training was undertaken on the 01/11/05 and 06/01/06. Residents expressed the view that they felt safe and ‘staff look after us very well’. She also commented that ‘ I can walk along the river and through town on my own, which is good’. All residents have the homes service users guide, which has user-friendly information in pictorial form concerning the making of a complaint. Residents spoken to were aware of their rights. Residents questionnaires returned to The Commission showed that all residents know who to speak to if they were unhappy and they also knew how to make a complaint. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, the standard of the environment and its facilities are appropriate and safe for the needs of residents. EVIDENCE: One resident showed the regulator around the home, taking in the bedrooms, toilets, bathrooms, showers and communal areas. Not all of the bedrooms were seen, as some service users were out and others did not want them to be seen. Those seen were large and had been personalised by the occupants. Six residents share bedroom, with the rest having single room accommodation. Residents returned questionnaires showed that seven of the eight returned indicated that the homes is always fresh and clean and one resident felt that the home is usually fresh and clean. The files of residents who were being case tracked contained a signed and dated letter by them giving staff can enter their rooms and clean when they are out. One resident comment that staff are very good they knock on my door and wait before they come in. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 19 The tour of the environment found that all toilets were in working order and bathrooms and showers had clean non- slip bath mats. The home was found to be clean and no offensive odours were detected. Some residents look after their own rooms and carryout all of the cleaning tasks with support required to maintain a good level of cleanliness and maintain their independent living skills. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The current management structure ensures that the home is managed for and with the residents. EVIDENCE: Recruitment practices were in place and two staff files contained all of the documentation required by law. It was also found that interview notes of new care workers employed at the home had not been kept for possible future reference. Each worker in the home has been given the General Social Care councils pack relating to the registration of care workers and the philosophy of the Care Council for all social care homes. The homes training plan was received by the Commission and found to be up to date. The training record identified the trainee manager and those care workers who had undertaken statutory training in 2005 and 2006. The trainee manager has National Vocation Qualifications (NVQ) training in care level 2 and 3 and is currently undertaking the registered managers award in management and care. One carer has commenced NVQ training and funding Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 21 has been applied for two other staff to undertake this training. All staff undertake The National Training Organisation for Social Care (TOPSS) training foundation courses. One carer stated that she had undertaken fire procedures, manual handling, and adult protection training. She also confirmed that she is attending NVQ training and undertaken (TOPSS) foundation training. She was also able to demonstrate a clear understanding of her role and responsibilities. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Appropriate checks are carried out to ensure the safety of residents. Systems are in place to ensure that service users, relatives/friends views were sought regarding the running of the home. EVIDENCE: The registered manager/provider is a qualified mental health nurse (RMNH) of many years experience both in hospitals and residential care, working with people who have a learning disability. She is supported by a trainee manager who is also experienced in working with residents with a learning disability. They have an open door approach to both residents and staff who require support and guidance. Residents confirmed that ‘Kath ( manager) is very nice’. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 23 evidenced that fire alarm, fire drill and emergency lighting checks are carried out as required. Staff also receive fire training as part of the homes initial training and as a regular training event. The homes induction training, which was seen on previous inspections showed that ‘policies and procedures are read and signed by staff and that they inform practice’. The homes pre-inspection questionnaire showed that; gas safety inspections have been carried out, electrical wiring checks, and portable electrical equipment checks. Since the last inspection risk assessments are now available for windows on the first floor, which have now been fitted with window restrictors. Residents and relatives/friends questionnaires are undertaken on a six monthly basis to seek their views regarding the care on offer at this home. The homes questionnaires have been used in this report to identify the views of residents and relatives, which have been found to be very positive. A summary of responses to the survey has been produced and is available to residents and relatives. Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 4 x 3 x x 4 x Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 25 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Clayton House DS0000002308.V299038.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!